TOPLINE:

Exposure to antibiotics within the first week of life was associated with reduced weight-for-height through 5 years of age, with the combination of Augmentin and gentamicin having the most pronounced effect on growth.

METHODOLOGY:

• Researchers examined growth patterns among children exposed to antibiotics during the first week of life and evaluated the effects of different antibiotic regimens on growth.
• They used data from two birth cohorts: A control group of 128 healthy, term-born infants (≥ 37 weeks of gestation), and a cohort of 147 term-born infants (≥ 36 weeks of gestation) who received antibiotics for suspected early-onset neonatal sepsis in the first week of life.
• The treated cohort was randomly assigned to receive one of three commonly prescribed broad-spectrum antibiotic regimens: penicillin plus gentamicin, amoxicillin plus cefotaxime, and Augmentin plus gentamicin.
• Primary outcomes were weight-for-age, height-for-age, and weight-for-height z-scores, evaluated through 5 years of age.

TAKEAWAY:

• Children older than 1 year who received systemic antibiotics in early life had on average 0.33 lower weight-for-age z-scores than unexposed children (P = .019).
• Across the first 5 years, early-life exposure to antibiotics was associated with on average 0.26 lower weight-for-height z-scores than no exposure (P = .014).
• The effect was most pronounced among children treated with Augmentin plus gentamicin, who had weight-for-height z-scores on average 0.36 lower than unexposed children (P = .013).
• Weekly lemonade consumption at 5 years of age was associated with higher weight-for-age z-scores (P = .010).

IN PRACTICE:

"Since antibiotic treatment in early life can be essential in certain cases, clinicians should consider the choice of regimen carefully, and diagnostic tools for appropriate initiation of antibiotics for early-onset neonatal sepsis are required to prevent overtreatment," the authors wrote.

SOURCE:

The study was led by Lisanne M. van Leeuwen, Department of Paediatrics, Spaarne Hospital, Haarlem, Netherlands, and was published online on October 07, 2025, in Acta Paediatrica.

LIMITATIONS:

The study used two birth cohorts that enrolled children in different years and had different initial objectives. It lacked data on parental weight and height, which could have helped estimate and correct for genetic drivers of participants' growth trajectories.

DISCLOSURES:

The study received support from the Chief Scientist Office, Spaarne Gasthuis stimuleringsfonds, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, NWO-VIDI, and ZonMw. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.